Cervical Papanicolaou Smear, Screening Without Physician Interpretation
Clinical Information Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test
Squamous cell carcinoma of the cervix is believed to develop in progressive stages from normal through pre-cancerous (dysplastic, intraepithelial neoplastic, stages II in situ carcinoma, and eventually invasive carcinoma). This sequence is felt to develop over a matter of years in most patients.
The etiology of cervical carcinoma is unknown but the disease is believed to be related to sexual activity and possibly sexually transmitted viral infections such as human papilloma virus.
Most cervical carcinomas and precancerous conditions occur in the transformation zone (squamo-columnar junction), therefore, this area needs to be sampled if optimum results are to be obtained.
Screening for cervical carcinoma and a number of infections of the female genital tract including human papilloma virus, herpes, Candida, and trichomonas
Standard reporting, as defined by the Bethesda System (TBS) is utilized.
Cautions Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances
If endocervical cells have not been obtained (less than optimal smears), the results may be unreliable.
There is a false-negative rate of 10% to 20% in the presence of cervical intraepithelial neoplasia or invasive squamous cell carcinoma.
The Pap test is unreliable for endometrial carcinoma (at least 50% false-negative rate).
Reference Values Describes reference intervals and additional information for interpretation of test results. May include intervals based on age and sex when appropriate. Intervals are Mayo-derived, unless otherwise designated. If an interpretive report is provided, the reference value field will state this.
Satisfactory for evaluation. Negative for intraepithelial lesion or malignancy.
Note: Abnormal results will be reviewed by a physician at an additional charge.
Clinical References Provides recommendations for further in-depth reading of a clinical nature
1. Wright TC Jr, Cox JT, Massad LS, et al: ASCCP-Sponsored Consensus Conference. 2001 Consensus Guidelines for the management of women with cervical cytological abnormalities. JAMA 2002 April;287(16):2120-2129
2. Solomon D, Davey D, Kurman R, et al: The 2001 Bethesda System: terminology for reporting results of cervical cytology-Consensus Statement. JAMA 2002 April;287(16):2114-2119